NR605/NR 605 Midterm Exam Questions with Verified Answers
(Correct Update)
Question 1: Lori, a 42-year-old female, presents to the office for an initial consultation. She has just
experienced a breakup after a 5-year relationship and is feeling "depressed." A comprehensive
initial evaluation which includes chief complaint, history or present illness, medical history, previous
psychiatric history, family history and a comprehensive review of systems was completed.
Psychotherapy was included in the session - 18 minutes time.
Answer: 99205+90833 Rationale: The client is new to the practice (20) and presents with one
problem which addressed 4 or more elements, had a comprehensive history and interview. No
additional testing was needed, treatment was initiated (05). Psychotherapy was included in the
session- 18 minutes time. Therapy goals were established and reviewed with the client.
Question 2: Hannibal, a 23-year-old male, is admitted to an inpatient psychiatric facility with
symptoms of auditory hallucinations, paranoia, and suicidal ideations. A comprehensive initial
evaluation which includes chief complaint, history or present illness, medical history, previous
psychiatric history, family history and a comprehensive review of systems was completed.
Answer: 99223 Rationale: The client presents for initial hospital care (22) and has a high level of
medical decisionmaking due to an acute illness that poses a threat to life (3).
Question 3: A client who is alert and oriented declines the PMHNP's treatment recommendation for
an antipsychotic in a non-emergent situation.
Answer: Informed consent required Rationale: The client has the capacity to consent and the
situation is not emergent. The ethic of autonomy provides for the client to refuse treatment
options.
Question 4: Ruben is a 36-year-old who has been in therapy for 5 months. He is in the process of
divorcing his wife of 12 years and is seeking custody of his daughter. His attorney has requested
copies of his psychotherapy notes to use in support of the custody hearing. Can the therapist choose
to share the psychotherapy notes?
Answer: Yes with written authorization from the client Rationale: the client must provide written
authorization for his notes to be shared with his attorney.
Question 5: Kathy is a 32-year-old who has been in court-mandated therapy for two months after
her children were removed from the home by Child Protective Services for suspected physical abuse
and neglect. The social worker has requested copies of her progress notes as a part of the
investigation. Is the therapist obligated to provide the progress notes?
Answer: Yes, no client authorization necessary Rationale: Because the notes were requested for a
health and human services investigation, the therapist may release the notes without client
authorization.
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(Correct Update)
Question 1: Lori, a 42-year-old female, presents to the office for an initial consultation. She has just
experienced a breakup after a 5-year relationship and is feeling "depressed." A comprehensive
initial evaluation which includes chief complaint, history or present illness, medical history, previous
psychiatric history, family history and a comprehensive review of systems was completed.
Psychotherapy was included in the session - 18 minutes time.
Answer: 99205+90833 Rationale: The client is new to the practice (20) and presents with one
problem which addressed 4 or more elements, had a comprehensive history and interview. No
additional testing was needed, treatment was initiated (05). Psychotherapy was included in the
session- 18 minutes time. Therapy goals were established and reviewed with the client.
Question 2: Hannibal, a 23-year-old male, is admitted to an inpatient psychiatric facility with
symptoms of auditory hallucinations, paranoia, and suicidal ideations. A comprehensive initial
evaluation which includes chief complaint, history or present illness, medical history, previous
psychiatric history, family history and a comprehensive review of systems was completed.
Answer: 99223 Rationale: The client presents for initial hospital care (22) and has a high level of
medical decisionmaking due to an acute illness that poses a threat to life (3).
Question 3: A client who is alert and oriented declines the PMHNP's treatment recommendation for
an antipsychotic in a non-emergent situation.
Answer: Informed consent required Rationale: The client has the capacity to consent and the
situation is not emergent. The ethic of autonomy provides for the client to refuse treatment
options.
Question 4: Ruben is a 36-year-old who has been in therapy for 5 months. He is in the process of
divorcing his wife of 12 years and is seeking custody of his daughter. His attorney has requested
copies of his psychotherapy notes to use in support of the custody hearing. Can the therapist choose
to share the psychotherapy notes?
Answer: Yes with written authorization from the client Rationale: the client must provide written
authorization for his notes to be shared with his attorney.
Question 5: Kathy is a 32-year-old who has been in court-mandated therapy for two months after
her children were removed from the home by Child Protective Services for suspected physical abuse
and neglect. The social worker has requested copies of her progress notes as a part of the
investigation. Is the therapist obligated to provide the progress notes?
Answer: Yes, no client authorization necessary Rationale: Because the notes were requested for a
health and human services investigation, the therapist may release the notes without client
authorization.
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